There is practically no person who does not experience back pain in the lumbar region at least once in his life. This is how we pay for walking upright and our daily habits.
In addition to the damage that can affect the spine, its muscles, nerves and ligaments, it should be borne in mind that sometimes the back hurts in the lumbar region with internal diseases - diseases of the kidneys, gastrointestinal tract and female genital organs.
Symptoms of low back pain can range from dull to sharp. The pain may go away on its own or become chronic (the symptom has been present for more than three months).
dangerous! You should immediately consult a doctor if:
- pain in the lumbar region appeared suddenly after an obvious back injury;
- the temperature has risen sharply, there are vegetative disorders, loss of consciousness, sweating, difficulty breathing;
- involuntary bowel and bladder emptying occurs;
- there is numbness in the groin area;
- there was weakness of the lower limbs, their paresis or paralysis, impaired sensitivity;
- the pain is given in the stomach and sharply increases when coughing or sneezing;
- symptoms appear against the background of sudden weight loss, long-term use of steroids, immunodeficiency;
- there were cases of cancer, inflammatory or degenerative diseases of bone and cartilage tissue in the family history.
Why does the back hurt in the lumbar region?
Myofascial pain
A muscle strain or spasm can develop gradually or suddenly. With a heavy load, the damage affects not only the muscle fibers, but also the ligament apparatus and the fascia.
Muscle pain in the lower back occurs after:
- lifting heavy weights or straining during work or sports;
- exercise occasionally. Muscles are especially vulnerable if you are inactive during the work week and then spend hours in the gym on weekends;
- a sharp increase in the weight of one's own body, behind which the muscles do not have time to grow;
- prolonged sitting or standing in an uncomfortable position;
- daily carrying a bag in one hand or over the shoulder;
- posture disorders. The spine performs its best supportive and protective function when you are not hunched over. The muscles in the lower back experience the least tension when you sit with good support under the lower back, and when you stand, you distribute the weight evenly on both legs.
If the back hurts after a bruise, fracture, sprain, hypothermia, an infectious disease or an established helminth infestation, then myositis (inflammation) of the muscles of the lower back can be suspected. There is constant severe pain due to inflammation of the muscle fibers, "knots" are felt in the muscles - places of spasm. Inflammation can be acute or take a chronic form. With a long course of the disease, the pain is unstable, aggravated by prolonged lying or sitting, in the late afternoon or when the weather changes. Touching the muscles causes a feeling of pain and discomfort, the muscles of the lower back are in constant tension, inflammatory edema is formed, the temperature rises locally and at the level of the whole organism.
With a muscle spasm, the roots of the spinal nerves are disturbed, so the attacks often look like a picture of sciatica or sciatica - there are burning severe pains on the back of the thigh and lower leg, the limbs go numb, lose sensitivity. Pronounced muscle tone in myositis makes the patient take a forced position, he walks and lies hunched over, moves on bent legs.
How to treat muscle pain in the spine? To eliminate inflammation and pain, non-steroidal anti-inflammatory drugs and analgesics are used. Medicines can be taken in the form of tablets, ointments, injections, transdermal patches with gradual release of the active substances. Irritating and warming ointments are also used, which reflexively increase blood flow to the muscles of the back. The greater volume of incoming blood contributes to washing away the products of inflammation and tissue breakdown.
Reduction of inflammatory edema is facilitated by injections of corticosteroids and vasoconstrictive drugs.
If the cause of myositis is an infection or poisoning of the body with toxins from worms, then antibiotics or anthelmintic drugs are initially used. In this case, warming ointments or compresses cannot be used.
Diseases of the spine involving nerve endings
In the lumbar region, the vertebrae are separated by elastic cartilage discs that protect the spine from injury, but are themselves subject to wear and aging.
Typically, the disc is a jelly-like nucleus pulposus surrounded by a denser layer of the annulus fibrosus. The elasticity of the core is due to its ability to bind and hold water: when the load increases, it accumulates water and the elasticity increases, when the pressure decreases, the core releases water and becomes flatter.
Osteochondrosis in the spinal region develops with malnutrition of the intervertebral discs (their "drying") or with excessive local loading. Most often, pain in the lower back is due to the fact that the lower poles of the intervertebral discs bear the greatest load when sitting, when lifting weights in front of them. At the same time, ruptures are formed, displacements in the discs, spinal ligaments are damaged, there is constant pain, pulsation.
Pain in the spine has several mechanisms of development:
- violation of microcirculation in the tissues around the spine and in particular in the spinal canal, the formation of congestion and edema. Such conditions develop against the background of hypothermia, overheating, inflammatory processes.
- degenerative processes in the fixing ligaments of the spine. Increasing the mobility of the vertebrae leads to their slight displacement and non-physiological compression, which leads to damage to the nerves, blood vessels and the formation of a hernia.
- axial compression of the vertebrae when lifting weights or damage to them during excessive rotation (turn).
- aseptic inflammation. Disruption of the core results in the release of sensitizing factors into the spinal canal. There is irritation of the nerve endings, which causes a spasm of the muscles that affect the adjacent vertebrae - above and below the hernia. Gradually, the reaction covers the entire lumbar region and leads to the fact that every movement causes a feeling of pain.
A weakened disc can rupture, leading to bulging, bulging, or prolapse of the nucleus and eventually herniation. The appearance of a hernia puts pressure on the spinal cord and spinal nerve roots. Under such conditions, a sharp throbbing pain appears in the lower back, which deviates along the strangled nerve. The most famous cases of compression of the sciatic nerve (sciatica), which are manifested by sharp pain along the back of the thigh and lower leg, numbness of the limb on the side of the hernia, muscle weakness, involuntary retraction of the leg.
Pain in the lumbar spine intensifies when sitting and standing, when turning, tilting. Often there is a protective muscle reaction - a painful contraction of the muscles (formation of rolls) on both sides of the spine, which isolates the department from unnecessary movement. Osteochondrosis subsequently leads to the appearance of sciatica (inflammation of the spinal nerve roots).
Radicular syndrome is dangerous when the nerves of the lower back, which are responsible for the innervation of the internal organs (horns of the cauda equina), are compressed. At the same time, the pain is given to the stomach, the function of the bladder and intestines is disturbed, there are problems with potency in men and gynecological diseases in women.
Many patients, due to the fact that the lower back hurts a lot, take analgesic positions - turn the body to the left, if the right side hurts, lie on the right side. If the hernia is on the left. The appearance of severe pain when pressing on the hernia in the intervertebral space (ringing symptom) is also characteristic.
How to treat yourself if your back hurts with osteochondrosis:
- during an attack of pain, you can take an anesthetic position - lie on your back and put a roll under your knees. It is also recommended to sleep on a hard surface;
- of the analgesic drugs, NSAIDs can be taken orally or as injections on both sides of the spine in the lumbar hotel;
- use local irritants as distraction therapy - mustard plasters, iodine mesh, black patch and ointments;
- elimination of miotic spasm through manual therapy, acupuncture, vacuum massage, reflexology, gymnastics;
- during the subsidence of the acute period, treatment with mud, ozokerite, heating can be used.
Treatment of radicular syndrome pain includes:
- providing bed rest, lumbar traction (dry or under water);
- the use of novocaine blockades at the site of the violation, the use of NSAIDs or weak opiates;
- physiotherapy - microcurrent stimulation, electrophoresis with analgesics.
Indications for surgery are constant acute pain, as well as impaired function of internal organs, development of limb paralysis, hernia sequestration in the spinal canal.
Degenerative inflammatory lesions
Spondylarthrosis (inflammation of the facet joints of the vertebrae) occurs with degeneration, a decrease in the height and volume of the intervertebral discs. Pain in the lower back occurs from overstretching the capsule and increasing pressure on the surface of the intervertebral joints. The pain causes the patient to bend more in the lower back, thus increasing the strain on the intervertebral joints. Especially the discomfort in the lower back is aggravated by wearing high-heeled shoes, prolonged walking, dismounting from elephants, positions when the body leans back, for example, when looking at something overhead.
In patients with this diagnosis, stiffness in the lower back is noticed in the morning, the pain increases during the day or after training. It has a diffuse character and it is difficult to clearly delineate the boundaries: the discomfort is determined in the gluteal muscles, the inguinal region, the lower abdomen and in the scrotum in men. This spondyloarthrosis differs from radicular syndrome when you can determine the source of pain.
What to do to relieve the pain? Lying down, bending the legs at the hip and knee joints usually helps.
Their medications are non-steroidal anti-inflammatory drugs and non-narcotic analgesics of choice.
Also added are muscle relaxants that ease muscle tension and improve spinal mobility.
Psychotherapy has a positive effect because chronic pain puts the patient in a state of depression.
Spondylosis, unlike osteochondrosis, affects more the fibrous ring of the intervertebral disc and the anterior longitudinal ligaments. In this disease, calcification of the connective tissue structures occurs with the formation of growths on the edge of the vertebrae - osteophytes. These formations cause a violation of microcirculation near the nerve roots and lead to the fact that the back hurts in the lower back, and the mobility of this department is also limited.
Vertebral osteophytes are pathological formations that damage nerves and blood vessels.
Treatment is usually conservative, using anti-inflammatory drugs, analgesics, vitamins. A good effect is given by electrophoresis with novocaine, lidase, manual therapy, physiotherapy (amplipulse, laser installation, shock wave therapy to destroy compacted elements and increase the mobility of the spine).
Note! In an advanced stage, osteophytes do not disappear. While their size is small, treatment is aimed at eliminating inflammation, pain, improving metabolism. If the back does not hurt much, then nothing is done with the growths. If osteophytes cause persistent pain or are large, they can be removed during surgery.
Diseases of a tumor nature
Low back pain can arise from compression of the spinal cord by a tumor from the outside (extramedullary formations) and from the inside (intramedullary, originating from the cerebrospinal substance itself).
Cells of various tissues can grow pathologically:
- fatty - a lipoma is formed;
- nerve roots - neuroma;
- vessels of the spinal cord - hemangioma;
- auxiliary tissue - glioma;
- bone tissue - osteosarcoma;
- cartilage - chondrosarcoma.
The tumor process, especially malignant, is characterized by a pain syndrome similar to sciatica (can be unilateral and bilateral), general deterioration of the patient's condition and exhaustion.
If the pathology affects the area of I-IV lumbar vertebrae, then there is a burning pain in the front and on the side of the upper thigh, incomplete paralysis of this area.
With a lesion in the region of the IV lumbar - II sacral segment, numbness of the paragenital area, impaired motor and sensory innervation of the gluteal muscles, the back of the thigh, the calf, fecal and urinary incontinence are noted.
A pronounced disorder in the functioning of the pelvic organs occurs with a neoplasm in the area of the V-III sacral vertebrae. The patient suffers from sexual impotence or menstrual disorders, constipation or incontinence of stool and urine.
Tumor treatment is specific, pain relievers and anti-cancer drugs are by prescription.
As you can see, lower back pain is usually caused by pathologies of the musculoskeletal system. They can be diagnosed by clinical signs and research data, the main task of which is to correctly determine the nature of the disease and not to confuse it with oncological causes, diseases of internal organs or trauma. If you are experiencing lower back pain, we recommend that you always seek advice from a neurologist or orthopedist.